Diferencia entre revisiones de «Flail chest»
(Text replacement - "Category:Pulm" to "Category:Pulmonary") |
(Text replacement - "pt's" to "patient's") |
||
| Línea 13: | Línea 13: | ||
*Pts w/ mild-moderate flail chest who are otherwise healthy may be managed w/o PPV | *Pts w/ mild-moderate flail chest who are otherwise healthy may be managed w/o PPV | ||
*Analgesia | *Analgesia | ||
*Consider intubation even if | *Consider intubation even if patient's breathing initially seems adequate, esp if: | ||
**Shock | **Shock | ||
**Severe head injury | **Severe head injury | ||
Revisión del 01:31 23 jun 2016
Background
- Due to segmental fxs (in 2 or more locations on same rib) of 3 or more adjacent ribs
- Leads to free-floating segment of ribs that no longer attach to rest of thorax
- Commonly associated w/ respiratory failure (due to pulmonary contusion)
Diagnosis
- Paradoxical inward movement of involved portion during inspiration
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Treatment
- Pts w/ mild-moderate flail chest who are otherwise healthy may be managed w/o PPV
- Analgesia
- Consider intubation even if patient's breathing initially seems adequate, esp if:
- Shock
- Severe head injury
- Comorbid pulmonary disease
- Fx of 8 or more ribs
- Age >65
- Surgical fixation is controversial